Dislocated Worker Special Project Report

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
13106	Dislocated Worker Special Project Report	Form	Migrated

ICR Details

OMB Control No: 1205-0318	ICR Reference No: 199803-1205-002
Status: Historical Active	Previous ICR Reference No: 199610-1205-004
Agency/Subagency: DOL/ETA	Agency Tracking No:
Title: Dislocated Worker Special Project Report
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/19/1998
	Date Received in OIRA: 03/19/1998
Terms of Clearance: Approved. DOL agrees to meet the following terms: 1) In regards to ETA's electronic data initiative: a) Once the WtW process of electronic verification is in place, ETA will make the necessary technical adjustments with the reporting of this form so that a paper copy and signature are no longer required, b) ETA will provide to OMB within 3 weeks of clearance a list of the states that currently report electronically, c) Prior to implementing the new oracle-based system, ETA will ensure that the system is Y2K compliant, d) ETA will continue their work with the Dislocated Worker Technology Demonstration and will update OMB on its progress in the next submission of this package; 2) In regards to changes to the form and instructions in order to increase the utility of reporting: a) ETA will remove section b (type of grant) as this information can be derived from the project ID, b) ETA will revise page 2 of the general instructions to clarify that respondents have to submit only 1 hard copy report, c) ETA will revise the form to implement the new race categories as outlined in the 10/30/97 Federal Register, d) ETA will revise the instructions on page 11 to be consistent with OMB's suggestion in its 5/18/98 memo to DOL; 3) ETA will begin a targetted research initiative to look into the following issues dealing with dislocated workers that are not covered by this form - - relocation allowances (e.g., out of area job search) and on the job training; 4) In the next submission of this package, ETA will look into providing respondents with collecting follow-up data through UI wage records.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2001	05/31/2001	05/31/1998
Responses	460	0	680
Time Burden (Hours)	4,968	0	11,870
Cost Burden (Dollars)	0	0	0

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Abstract: The information will be used to assess Defense, Clean Air, and title III National Reserve projects. Participant and financial data will be used to monitor program performance and to prepare reports and budget requests.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Dislocated Worker Special Project Report	ETA-9038

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	460	680	0	-220	0	0
Annual Time Burden (Hours)	4,968	11,870	0	-6,902	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/19/1998

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